Common household plastics linked to over 350,000 deaths from heart disease, study says

Researchers estimate that exposure to phthalates contributes to 13 per cent of all heart disease deaths in people between the ages 55 and 64 each year worldwide.

A set of chemicals found in food packaging, plastics, and lotions and shampoos has been linked to hundreds of thousands of deaths from heart disease, according to a study published Tuesday in the journal eBioMedicine.

These chemicals, known as phthalates (pronounced tha-lates), were responsible for more than 350,000 deaths worldwide in 2018, researchers found. About 75 per cent of the deaths were in Asia, the Middle East and the Pacific — reflecting growing concern about the amount of plastic proliferating in developing countries.

“We think of plastics as an issue in high-income countries,” said Leonardo Trasande, a professor at the New York University Grossman School of Medicine and one of the authors of the paper. “But what we’re seeing in the pattern geographically is disturbing.”

While the researchers acknowledge that exposure to phthalates coincides with other risk factors, such as obesity and metabolic disorders, the findings add to the growing evidence that chemicals used in plastics come with serious health risks.

Phthalates are a set of chemicals that are added to plastic to make it more stretchy, soft or flexible. In lotions, shampoos and perfumes, phthalates can be used to retain scents. But the chemicals — which are so common that some researchers call them “everywhere chemicals” — have attracted widespread concern from scientists.

In epidemiological studies, phthalates have been linked to male fertility problems, heart disease, obesity and ADHD. The United States allows nine kinds of phthalates to be used in food packaging. They are an example of what scientists call “endocrine-disrupting chemicals,” which can tweak and change the hormones in the body, causing multiple health problems.

“We already know that phthalates are toxic chemicals,” said Tracey Woodruff, a professor of obstetrics, gynaecology and reproductive health at the University of California at San Francisco, who was not involved in the study. In recent years, she pointed out, scientists and environmental organisations have pushed lawmakers to get phthalates out of food packaging and other plastics. “This just shows why that’s a good idea,” Woodruff added.

Kevin Ott, the executive director of the Flexible Vinyl Alliance, which represents the makers of polyvinyl chloride, said in an email that many studies on the health risks of phthalates do not meet the highest standards of evidence. The Food and Drug Administration confirmed as recently as 2018 that phthalates are not clearly linked with any health effects, Ott added.

The new study drew on surveys from around the globe that evaluated exposure to food pack, one particular type of phthalate, through urine samples. Researchers then matched exposure to the chemical to increased risk of cardiovascular death.

They found that phthalates contributed to 13 percent of all deaths from heart disease in people between ages 55 and 64 globally. In the United States, it was around 10 percent. Cardiovascular disease is the leading cause of death worldwide: In 2021, an estimated 20 million people died because of heart disease.

Trasande says that while 13 per cent may seem like a high number, phthalate exposure may overlap with and exacerbate other risks. Phthalates are believed to create excess inflammation in the body, and they are linked with other conditions that increase heart disease mortality, such as obesity and high blood pressure. Some of the increased risk of heart disease from obesity, for example, could be from phthalates. The chemicals are also found more commonly in highly processed foods, another risk factor for death from heart disease.

Scientists estimate that air pollution, which contains tiny plastic particles, is linked to 20 per cent of all cardiovascular deaths globally.

Recent research, albeit with a small sample size, has also found that the presence of microplastics or nanoplastics in the carotid artery increases the risk of heart attack, stroke or death. Researchers are trying to understand the extent to which those tiny plastics can carry chemicals like phthalates with them.

But people with more phthalates in their bodies are probably more exposed to plastics, and therefore to microplastics and nanoplastics as well, Trasande said.

“It could be the chemicals that are being delivered, or it could be the micro and nanoplastics,” said Trasande. “And that’s really where the field needs to go scientifically.”

Other research looking at deaths from phthalates has come to similar results. One study published late last year found that phthalates were responsible for about 164,000 deaths worldwide in 2015, most due to heart disease and high blood pressure. That study examined just 40 countries, while the new study looked at around 190.

While animal studies have also found connections between phthalates and heart disease, some researchers say more human studies would help solidify the link. “It would be important to have someone do a systematic review on phthalates and cardiovascular events,” said Woodruff. “But it’s just a new area.”

For now, scientists continue to push for more monitoring of the chemicals in plastic. In most countries around the world, companies are not required to reveal chemical additives to plastics, which include things like phthalates, BPA and flame retardants. Many of those plastics end up in low-income countries along with mountains of plastic waste for recycling or disposal.

“They are the receivers of all the plastic garbage,” Woodruff said. “And the phthalates are going to be there, too.